The Robert Wood Johnson Foundation (RWJF) has released a report showing that one in eight Medicare patients were readmitted to the hospital within 30 days of being released after surgery in 2010, while patients in the hospital for reasons other than surgery returned at an even higher rate of one in six. Both rates were virtually unchanged from 2008. The findings are based on new data that includes readmission rates for states, hospital referral regions, and more than 3,000 hospitals from the Dartmouth Atlas Project, largely funded by RWJF. The report, “The Revolving Door: A Report on U.S. Hospital Readmissions,” also includes the results of a novel series of in-depth interviews with patients and providers that shed light on why so many patients end up back in the hospital and what hospitals, doctors, nurses, and others are doing to limit avoidable readmissions.

The issue of patients being readmitted to the hospital is considered important because many are avoidable and, as the report notes, can occur because of differences in patient health status; the quality of inpatient care, discharge planning, and care coordination; the availability and effectiveness of local primary care; and the threshold for admission in the area. The Centers for Medicare & Medicaid Services (CMS) began reductions in Medicare reimbursement last year for hospitals with high rates of readmissions.

This report, supported by The John A. Hartford Foundation, explores the care experienced by older adults in the U.S., including the number and types of care providers they see, along with the frequency with which they have contact with the health care system. It identifies areas where improvements are most needed and recognizes areas in which improvements are already under way. Finally, it notes the distinctive challenges and opportunities presented by people with multiple chronic conditions and dementia. Read the report, policy-oriented or consumer-oriented press release, download data tables, or purchase a copy.

A casual reader of The New York Times article by Kevin Quealy and Margot Sanger-Katz, "The Experts Were Wrong about the Best Places for Better and Cheaper Health Care," would be forgiven if they missed this critical point. By focusing only on total spending—price times quantity—they give the impression that Medicare data tells us nothing about private insurance markets. Not so.

The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health
Policy and Clinical Practice and is supported by a coalition of funders led by the Robert Wood Johnson Foundation,
including the WellPoint Foundation, the United Health Foundation, the California HealthCare Foundation, and the Charles H. Hood Foundation.